Salivary stone removal

What is salivary stone removal?

Saliva is made by glands in the mouth and travels to the mouth through small tubes called ducts. A stone (sialolith) can form and block the flow, most often in the gland under the jaw (the submandibular gland). The classic sign is a gland that swells and aches when you eat or even think about food, then settles again afterwards. A blocked gland can also become infected.

Many small stones pass on their own with simple measures — keeping well hydrated, gentle massage towards the mouth, warm compresses, and sucking something sharp such as a lemon sweet to get the saliva flowing. Treatment to remove a stone is for stones that will not pass and keep causing symptoms.

How a stone is removed depends mainly on its size and where it sits. A stone near the opening of the duct can often be removed through the mouth under local anaesthetic. A stone further back may be removed using a fine telescope passed into the duct (sialendoscopy), sometimes combined with a small cut. The aim wherever possible is to clear the stone and keep the gland, rather than remove the whole gland.

Clearing the stone usually relieves the symptoms it was causing. It does not stop new stones forming in future, and not every stone can be removed without taking the gland out — your surgeon will explain what is realistic for you.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Keeping the gland vs removing the gland

Modern care tries to clear the stone and keep the gland wherever possible. Removing the whole gland is usually reserved for stones that cannot be reached or a gland that is badly damaged or repeatedly infected. Your surgeon will explain which applies to you.

Preparing for your procedure

• See the oral and maxillofacial surgeon to confirm a stone is the cause and to plan the best way to remove it.
• Have any scan needed (such as an ultrasound or other imaging) to show the stone's size and position.
• Tell the team about all medicines, especially blood thinners, and any bleeding tendencies.
• If sedation or a general anaesthetic is planned, follow fasting instructions and arrange a lift home.
• Stay well hydrated beforehand, and ask whether to keep up massage and saliva-stimulating measures.
• Plan any time off according to the technique, and have soft foods and painkillers ready if advised.

What happens

What happens depends on the stone. A stone near the opening of the duct is often removed through a small cut inside the mouth under local anaesthetic, so the area is numb but you are awake. The stone is eased out and the area is left to heal, sometimes with a dissolvable stitch.

For a stone further back, a very fine telescope (sialendoscopy) may be passed along the duct to find it. The stone can be caught in a tiny basket, or broken into smaller pieces and removed, and a small stitch may be placed to keep the duct open. Deeper or larger stones may need sialendoscopy combined with a small cut.

The procedure usually takes about 30–60 minutes. Most people go home the same day. Local-anaesthetic procedures often need little or no time off, while sedation or a general anaesthetic means arranging a lift home and not driving that day.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The main specific risks are not clearing the stone, the duct narrowing afterwards, and irritation of the nerve to the tongue (which gives feeling and taste), especially for stones in the submandibular duct. Most numbness is temporary. Clearing the stone does not stop new stones forming. Ask your surgeon how likely your stone is to be removed in one go, what the plan is if it cannot be, and whether your gland can be kept.

Published figures to discuss

Reliable single percentages are hard to give because techniques, stone size and stone position vary so much, so cautious wording is used here. The main issues are whether the stone can be fully removed, whether the duct narrows afterwards, and irritation of the nerve to the tongue for submandibular stones. Success and complication rates depend heavily on the individual stone.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery is usually quick, especially after a local-anaesthetic procedure through the mouth — many people are back to normal within a day or two, with some soreness and swelling of the gland while it settles.

• Soreness and swelling of the gland or under the tongue for a few days
• A small amount of bleeding or oozing inside the mouth at first
• Mild discomfort when eating that eases as the area heals
• Saliva flowing more freely once the blockage is cleared
• A dissolvable stitch inside the mouth that disappears on its own

Aftercare

• Stay well hydrated to keep saliva flowing.
• Keep the mouth clean with gentle salt-water rinses if advised, especially after a cut inside the mouth.
• Eat soft, cool foods at first and avoid very hard or hot foods while sore.
• Take painkillers as advised and any antibiotics exactly as prescribed.
• Continue gentle gland massage and saliva-stimulating measures if your surgeon recommends them.
• Avoid strenuous activity for a day or two if you had sedation or a general anaesthetic.
• Do not drive on the day of sedation or a general anaesthetic.
• Know the signs of infection and who to contact if symptoms return.

• Plenty of fluids to keep saliva flowing
• Soft, cool foods ready at home
• Recommended painkillers and any antibiotics collected
• Salt for salt-water rinses if advised
• A lift home arranged if having sedation or a general anaesthetic
• Any time off work booked according to the technique
• The clinic's contact number saved for problems

Scars and how they heal

Many techniques work through the inside of the mouth or along the duct, so there is no scar on the skin. A small cut inside the mouth heals over the following weeks, usually with a dissolvable stitch. If a stone is very deep and a skin approach is needed, your surgeon will explain where any scar would be and what to expect.

⚠ Get urgent help if…

• Spreading redness, heat, swelling or pus around the gland (possible infection)
• A high temperature or feeling generally unwell
• Swelling under the tongue or in the floor of the mouth that makes swallowing or breathing difficult — seek urgent help
• Bleeding inside the mouth that does not stop with gentle pressure
• Severe or worsening pain after the first day or two
• Numbness or altered taste on the tongue that is not improving

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

Removing the stone usually relieves the swelling and pain that came on when eating, and lets saliva flow freely again. Gland-sparing techniques keep the gland working and often avoid a skin scar.

Clearing the stone treats the blockage you have now, but it does not stop new stones forming in the future, and a small number of people develop narrowing of the duct or need further treatment. Occasionally a stone cannot be removed and the gland is taken out instead. A good surgeon explains how likely your stone is to be cleared in one go and what the plan is if it cannot be.

Once a stone is cleared and saliva flows freely, symptoms from that stone usually settle for good. However, some people are prone to forming salivary stones and may develop new ones over time, sometimes needing further treatment. Staying well hydrated, keeping good mouth hygiene and stimulating saliva flow may help reduce the chance of new stones, though they can still occur.

Related tests, treatments or support

Salivary stone removal is sometimes combined with treatment of duct narrowing found at the same time, or with a wash-out of the duct. If a stone cannot be cleared, or the gland is badly damaged or repeatedly infected, removal of the gland may be discussed instead — usually as a separate, larger operation.

Follow-up & long-term care

You should be told who to contact if symptoms return, and many people need no routine review after a straightforward stone removal. If you have repeated stones, duct narrowing, or symptoms that persist, your surgeon arranges follow-up to check for a remaining or new stone and to discuss further options.

• Stay well hydrated to keep saliva flowing.
• Keep up good mouth hygiene and regular dental care.
• Use gentle gland massage and saliva-stimulating measures if you are prone to stones.
• Report any return of swelling or pain on eating, so a new or remaining stone can be checked.

Repeat, follow-on and what comes next

• If a stone cannot be fully removed, a different technique or a repeat procedure may be needed.
• Duct narrowing afterwards can require a procedure to reopen the duct.
• Some people form new stones and need further treatment over time.
• If the gland is badly damaged or repeatedly blocked, removal of the gland may eventually be discussed.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear advice on hydration, mouth care, painkillers and warning signs, with a named contact.
• A plan for what to do if symptoms return or a new stone forms.
• Review if symptoms persist, to check for a remaining stone or duct narrowing.
• Honest discussion of the chance of keeping the gland and of recurrence.
• Advice on reducing the chance of new stones where possible.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The size and position of the stone and the technique needed
• Whether it is done under local anaesthetic, sedation or a general anaesthetic
• Whether sialendoscopy equipment or a combined approach is needed
• Any scans (such as ultrasound) needed to plan treatment
• The surgeon's fee and any facility or theatre fees
• Follow-up appointments and the plan if the stone cannot be cleared

• The surgeon's fee and what the procedure covers
• The anaesthetic option (local, sedation or general) and any extra cost
• Whether sialendoscopy or a combined approach is included
• Any imaging (such as ultrasound) needed beforehand
• Follow-up appointments and any further procedures
• The cancellation policy
• What happens, and who pays, if the stone cannot be removed or comes back

On the NHS? Salivary stone removal is available on the NHS when there is a clear clinical reason; private care may be used for speed or choice, but the gland-sparing approach should be the same.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the surgeon is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• How big is my stone and where is it — and which technique would suit it?
• How likely is it that the stone can be removed in one go?
• Can my gland be kept, or might it need removing?
• What is my risk of numbness or altered taste on the tongue?
• What happens if the stone cannot be cleared, or comes back?
• Is there anything I can do to reduce the chance of new stones?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for salivary stone removal

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Salivary gland stones BAOMS — patient information leaflets Treatment of sialolithiasis: updated algorithms and review (PMC) Sialoendoscopy and combined approach for salivary gland stones (PMC)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.